Brain Injury, 20 August 2005; 19(9): 685–691

ORIGINAL PAPER

Brief assessment of severe language impairments: Initial validation

of the Mississippi aphasia screening test

R. NAKASE-THOMPSON1, E. MANNING2, M. SHERER1,2, S. A. YABLON1,2,

S. L. T. GONTKOVSKY1, & C. VICKERY1
1
Methodist Rehabilitation Center, Jackson, MI, USA and 2University of Mississippi Medical Center, MI, USA

(Received 2 April 2004; accepted 8 November 2004)

Abstract
Primary objective: To validate the Mississippi Aphasia Screening Test (MAST) which includes nine sub-scales measuring
expressive and receptive language abilities.
Research design: Evaluation of inpatients admitted to neurology, neurosurgery or rehabilitation units at two local hospitals and
who were within 60 days of onset of a unilateral ischemic or haemorrhagic stroke (left hemisphere (LH; n ¼ 38); right hemi-
sphere (RH; n ¼ 20)). Additional participants were recruited from the community to comprise a non-patient control sample
(NP; n ¼ 36).
Methods: Data collection included administration of the MAST and chart review.
Results: The LH group showed more impairment than the RH and NP groups on summary scores. The LH group performed
worse than the NP group on all sub-scales. The object recognition and verbal fluency sub-scales did not discriminate the
stroke groups.
Conclusion: Analyses suggest good criterion validity for the MAST in differentiating communication impairments among
clinical and control samples.

Keywords: Stroke, aphasia, assessment, screening, cognitive

batteries may not be useful for serial evaluation.

Introduction
Individuals with acquired brain injury may demon-
strate communication impairment, particularly
during early recovery. Focal left hemisphere lesions
may cause marked language impairment acutely and
result in persistent aphasia with subsequent adverse
implications for treatment and long-term outcome
[1–3]. The degree of language impairment among
severely aphasic individuals is often under-estimated
by doctors, nurses and relatives of patients [4].
Clinicians often serially assess communication skills
and language function. This yields information to
guide medical and rehabilitation interventions,
detect improvement or decline in clinical status,
provide feedback to family and assist with post-
discharge planning. For patients with severe
language impairments, lengthy language assessment
A brief instrument that surveys a broad array
of language and communication abilities is more
suited to tracking patients’ progress through their
early clinical course to provide accurate information
to both family and clinicians.
Individuals with severe language impairment are
challenging to evaluate. The length of comprehensive
language batteries such as the Western Aphasia
Battery and Boston Diagnostic Aphasia Examina-
tion require 90 minutes and up to 2 hours to admin-
ister (and may take up to 8 hours in some patients)
[5–7]. Other measures have been developed that
are relatively more brief (i.e. shortened version of
the Minnesota Aphasia Test, Boston Assessment
of Severe Aphasia; and Multi-lingual Aphasia Exami-
nation) but still require 30–45 minutes in administra-
tion time [8–12]. The major disadvantages of using

Correspondence: Risa Nakase-Thompson, PhD, Department of Neuropsychology, Methodist Rehabilitation Center, 1350 East Woodrow Wilson Drive,
Jackson, MI 39216, USA. Tel: 1.601.364.3448. Fax: 1.601.364.3558. E-mail: nakase@aol.com
ISSN 0269–9052 print/ISSN 1362–301X online # 2005 Taylor & Francis Group Ltd
DOI: 10.1080/02699050400025331
686 R. Nakase-Thompson et al.
these language batteries with severely aphasic
patients are that small improvements over time may
not be reflected in summary scores and patients
may be frustrated by the lengthy testing interval.
Other language tests are brief in administration
but evaluate a limited number of abilities such as
the Boston Naming Test, Token Test or Controlled
Oral Word Association Test [11, 13, 14]. As a
result, common practice involves administering test-
ing batteries that encompass many different
individual tests across multiple sessions to assess
patients’ evolving abilities [5, 15]. Performance
differences from one part of the battery to another
may reflect evolution of symptoms between two
testing sessions. The need for a brief screening
instrument that could be completed within a single
therapy session, bedside evaluation or clinic appoint-
ment has been previously highlighted and develop-
ment of such a measure would address some of the
limitations of comprehensive language batteries
[15, 17]. Some brief tests have been developed
to address some of these issues. For example,
the Frenchay Aphasia Screening Test (FAST) was
developed as a tool for non-cognitive specialists to
identify persons with linguistic difficulties to be
referred for more comprehensive assessment [12].
The FAST has four sub-scales (comprehension,
expression, reading and writing) that identify
probable aphasia. However, the FAST was not devel-
oped to assist with monitoring progress over time or
goal planning [12]. The Aachen Aphasia Bedside
Test was developed in Germany as a measure of
language functioning to be used with persons who
are in the first 1–2 months post-stroke but studies
of this measure are all in German and not available
in English [17].
The Mississippi Aphasia Screening Test (MAST)
was developed as a brief, repeatable screening mea-
sure for individuals with severely impaired communi-
cation/language skills. Such a brief measure may be
advantageous for individuals with severe language
impairments who may be frustrated and stressed by
lengthy testing sessions. The MAST was designed
for serial assessment of changes in language abilities
over time and requires 5–10 minutes to administer.
The purpose of this paper is to demonstrate initial
psychometric and clinical properties of the MAST
and to provide descriptive information regarding
performance of patient and non-patient groups on
this test.
Methods
Subjects
Patients with stroke admitted to neurology, neuro-
surgery or rehabilitation units at two local
hospitals (Level 1 trauma centre and rehabilitation
hospital) and who received the MAST as part of
neuropsychological consultations administered by
neuropsychologists or specially trained psychometri-
cians between 15 June 2001–31 December 2002 were
potential subjects. All were within 60 days of the onset
of a unilateral ischemic or haemorrhagic stroke.
Individuals with unilateral strokes who were greater
than 60 days post-stroke (n ¼ 8) and individuals with
bilateral strokes (n ¼ 10) were excluded. Subjects who
did not receive a MAST as part of a bedside
examination or did not complete the entire MAST
were not included. Thus, the study sample was not
consecutive. If subjects received more than one
MAST, only the first observation (one closest to the
time of onset) was analysed for study purposes.
Participants were classified into either a left-
hemisphere (LH) or right-hemisphere stroke group
(RH) based on neuroimaging data.
Non-patient control participant data were col-
lected by occupational therapy students who were
enrolled in an allied health profession programme.
These students were enrolled in a class focusing on
administration of cognitive and functional clinical
measures. They were trained in administration of
the MAST and were asked to collect data from
friends and family. The students were instructed
to only collect data from individuals who were
18 years of age or older and did not have a history
of neurological dysfunction, such as stroke, trau-
matic brain injury or dementia. Participants recrui-
ted from the community comprised the non-patient
control group (NP). These subjects were not
expected to demonstrate difficulties with the brief
screening instrument.
Measure
The Mississippi Aphasia Screening Test (MAST) was
initially developed by a team of neuropsychologists,
physicians and speech-language pathologists. Fifteen-
to-thirty items were initially generated for each sub-
scale then pilot-tested and revised to form the current
test (see sample items in appendix 1). The current
form has nine sub-tests: (a) Naming, (b) Automatic
Speech, (c) Repetition, (d) Yes/No Accuracy, (e)
Object Recognition from a Field of Five, (f ) Following
Verbal Instructions, (g) Reading Instructions, (h)
Verbal Fluency, and (i) Writing/Spelling to Dictation.
The test takes
5–10 minutes to administer and yields
nine sub-test scores, two index scores (Receptive &
Expressive Language Index) and a total score. Each
sub-scale sums to 10 points with the exception of
the Yes/No Accuracy sub-scale which sums to 20.
The Index scores sum to 50 points each and are
added for the MAST Total Score (0–100 points).
Stimulus materials include one photograph, five

written instructions and five common objects
available in most hospital or clinic settings.
The MAST is available online or by contacting the
first author [18].
Chart review
Demographic and medical information was abstrac-
ted by chart review in both the Level I trauma centre
and rehabilitation hospital. Information abstracted
included age, gender, handedness, educational level,
neuroimaging findings and duration of time since
stroke to administration of initial MAST.
Statistical analyses
Descriptive statistics were generated by group for the
demographic variables of age, educational level,
handedness and gender as well as for the nine
sub-scales and three summary scores of the MAST.
Time since stroke, which was the duration of time in
days between the patient’s stroke and administration
of the MAST was also calculated for the patient
groups. Analyses of variance (ANOVAs), indepen-
dent t-tests or chi-square analyses, as appropriate,
were conducted to assess for between-group
differences across demographic variables. Pearson’s
product moment correlation coefficients were com-
puted to examine the degree of association between
demographic variables and MAST scores in the
control group. In order to protect against inflation
of Type I error, multi-variate analysis of covariance
(MANCOVA) was utilized to assess for between-
group differences across the 12 measures of the
MAST, controlling for differences between groups
with respect to demographic variables that were found
to be significantly associated with test performance.
Significant between-group effects on the MAST were
examined using Bonferroni post-hoc analyses. Three
independent discriminant function analyses were also
computed to determine classification rates by group
Table I. Demographic characteristics of sample by group.
Non-patient group
Age, M (SD) 46.6 (19.2)
Education, M (SD) 13.8 (2.1)
Duration, M (SD) — 22.2 (15.6)
Gender
Male 36%
Female 64%
Handedness
Left 11%
Right 89%
Unknown 0%
Note: Age and education are measured in years, duration in time is characterized in days from stroke to MAST
assessment, LH ¼ Left Hemisphere Stroke, RH ¼ Right Hemisphere Stroke.
Severe language impairments 687
using the MAST individual sub-tests, MAST
Expressive and Receptive Indices and MAST Total
Score, respectively.
Results
Thirty-eight individuals comprised the left-
hemisphere stroke group (LH) and 20 comprised
the right-hemisphere stroke group (RH). Thirty-six
subjects were recruited from the community to
comprise the non-patient control sample (NP). A
summary of demographic variables is presented by
group in Table I. Educational level was unknown
for 12% of the participants and handedness was
unknown for 3% of the participants. ANOVAs
revealed significant between-group differences both
for age, F(2, 90) ¼ 8.67, p < 0.0005 and educational
level, F(2, 79) ¼ 4.28, p ¼ 0.017. Post-hoc pairwise
comparisons utilizing a liberal level of significance for
interpretation (Bonferroni level of significance is
0.017 for three groups) indicated the NP group to be
significantly younger than either the LH group
( p < 0.0005) or the RH group ( p ¼ 0.025). The NP
group had significantly more years of education than
the RH group ( p ¼ 0.032). No significant difference
was found to exist between groups with respect to
gender, 2(2, n ¼ 93) ¼ 3.10, p > 0.05, or handed-
ness, 2(2, n ¼ 90) ¼ 0.94, p > 0.05. Additionally, the
patient groups were not found to differ in duration of
time between the stroke and administration of the
MAST, t(55) ¼ 0.69, p > 0.05.
Results of correlational analyses between MAST
performance and demographic variables in the
NP group are presented in Table II; p-values are
reported for descriptive purposes only and are not
corrected for multiple comparisons. Correlations
were defined as significant for purposes of covar-
iance, however, only when p-values were <0.01.
Age, education and handedness were significantly
associated with scores on the Expressive Index
and Total Score. Age and handedness were also
Patient groups
LH RH p
61.7 (12.7) 58.7 (15.7) <0.0005
12.2 (3.6) 11.6 (2.3) 0.017
19.3 (14.8) >0.50
>0.05
49% 60%
51% 40%
>0.05
5% 5%
87% 95%
8% 0%
688 R. Nakase-Thompson et al.

Table II. Correlations between demographic variables and MAST scores in non-patient group.

MAST scale Age Education Gender Handedness

Naming — — — —
Automatic speech 0.07 0.14 0.13 0.06
Repetition — — — —
Yes–no 0.25 0.15 0.32 0.09
Writing to dictation 0.21 0.23 0.13 0.06
Object recognition — — — —
Following verbal instructions 0.15 0.01 0.15 0.08
Following written instructions 0.12 0.21 0.07 0.09
Verbal fluency 0.36* 0.28 0.03 0.37*
Expressive index 0.39* 0.33* 0.08 0.37*
Receptive index 0.16 0.03 0.33* 0.15
Total score 0.44y 0.34* 0.01 0.41*

Note: MAST ¼ Mississippi Aphasia Screening Test.

*p < 0.05, y p < 0.01, Missing numbers indicate no variance among items correlated.

Table III. MAST performance by group.

Patient groups

MAST scale Non-patient group LH RH F ( p)* 2

Naming 10.0 (0) 4.3 (4.2) 7.6 (3.2) 25.0 (<0.0005)abc 0.36
Automatic speech 9.9 (0.7) 5.4 (3.8) 8.4 (3.1) 16.8 (<0.0005)ab 0.28
Repetition 10.0 (0) 4.8 (4.0) 8.2 (3.3) 23.2 (<0.0005)ab 0.34
Yes–no 19.9 (0.5) 14.5 (5.7) 17.8 (4.4) 11.2 (<0.0005)ab 0.20
Writing to dictation 9.9 (0.7) 1.7 (3.4) 5.5 (4.1) 55.6 (<0.0005)abc 0.56
Object recognition 10.0 (0) 6.2 (4.4) 8.1 (3.7) 8.7 (<0.0005)a 0.16
Following verbal instructions 9.9 (0.4) 4.5 (3.7) 7.8 (3.5) 25.2 (<0.0005)abc 0.36
Following written instructions 9.9 (0.5) 2.6 (3.7) 6.6 (3.7) 45.4 (<0.0005)abc 0.51
Verbal fluency 6.4 (3.5) 3.1 (4.3) 5.3 (4.4) 3.2 (<0.05)a 0.07
Expressive index 46.2 (3.7) 19.3 (16.2) 34.9 (15.8) 29.9 (<0.0005)abc 0.40
Receptive index 49.7 (0.7) 27.9 (15.1) 40.3 (14.2) 24.4 (<0.0005)abc 0.35
Total score 95.9 (3.6) 47.2 (29.9) 75.2 (29.1) 29.9 (<0.0005)abc 0.40

Note: MAST ¼ Mississippi Aphasia Screening Test; LH ¼ Left Hemisphere Stroke; RH ¼ Right Hemisphere Stroke.
a
Left hemisphere patient group scores significantly lower than non-patient group scores, b Left hemisphere patient group scores significantly
lower than right hemisphere patient group scores, c Right hemisphere patient group scores significantly lower than non-patient group scores.
* degrees of freedom ¼ (2, 89). Group performance scores are means and standard deviations.

significantly associated with scores on the Verbal
Fluency sub-test and gender was significantly
associated with scores on the Receptive Index.
Mean scores of the groups across the nine sub-
scales and three summary scores of the MAST are
presented in Table III. MANCOVA using age as a
covariate, indicated a significant main effect for
group, F(18, 162) ¼ 6.26, p < 0.0005. In a separate
analysis, the main effect was found to remain signifi-
cant in the absence of age covariation. Subsequent
examination of univariate analyses revealed signifi-
cant between-group differences across all 12 scores
of the MAST, with partial eta-squared effect sizes
ranging from 0.07–0.56 (see Table III). As expected,
results of post-hoc pairwise comparisons indicated
the LH group performed significantly poorer than
did the NP group across all 12 MAST scores
( ps < 0.003). The LH group also performed sig-
nificantly poorer than did the RH group on 10
of the 12 measures of the MAST ( ps < 0.02).
Additionally, the RH group performed significantly
poorer than did the NP group on seven of the 12
MAST scores ( ps < 0.03).
Results of discriminant function analyses yielded
correct classification rates of 74.2%, 69.9% and
71.0% for the sample using the MAST individual
sub-tests, MAST Expressive Index and Receptive
Index and MAST Total Score, respectively. As can
be seen in Table IV, the majority of incorrect classi-
fications occurred for the RH group (30% correct)
since the majority were misclassified as being in the
non-patient group. In all analyses, correct classifica-
tion rates exceeded 62% for the LH group and 97%
for the NP group.
Discussion
Current findings indicate strong evidence for the
criterion validity of the MAST. MAST total, index
and sub-scale scores differentiated individuals

Table IV. Group classification based on discriminant functional analysis.
Actual group membership Left hemisphere stroke
MAST sub-tests
Left hemisphere stroke
Right hemisphere stroke
Non-patients
Total correct ¼ 69/93 (74.2%)
MAST expressive index and receptive index
Left hemisphere stroke
Right hemisphere stroke
Non-patients
Total correct ¼ 65/93 (69.9%)
MAST total score
Left hemisphere stroke
Right hemisphere stroke
Non-patients
Total correct ¼ 66/93 (71.0%)
Note: MAST ¼ Mississippi Aphasia Screening Test.
with left hemisphere stroke from normal controls
and differentiated patients with left hemisphere
stroke from those with right hemisphere stroke.
MAST scores are sensitive to language impairments
associated with dominant hemisphere injury.
As expected, patients in the LH group scored
more poorly than the NP group on all MAST total,
index and sub-test scores. The MAST demonstrates
excellent sensitivity and specificity in detecting
language impairment and correctly discriminating
language impaired individuals (LH group) from
normal controls (NP group). Using summary
scores, none of the NP group members were misclas-
sified yielding 100% correct classification for non-
patients. Depending on which sub-tests or summary
scores were used,
62–76% of the LH group
members were correctly classified. As expected,
the MAST total, index and sub-test scores were
highly effective in distinguishing patients with left
hemisphere stroke from non-patients.
The MAST total and index scores were also distin-
guished patients with left hemisphere stroke from
those with right hemisphere stroke. The LH group
was more impaired than the RH group on the
MAST total and index scores as well as seven of the
nine sub-test scores. The two sub-scales for which
LH group members were not more impaired than
RH group members were object recognition from a
field of five and verbal fluency. Both of these tasks
require the respondent to visually scan stimuli. The
observations indicated that such tasks were difficult
for patients with left neglect. This may explain the
failure of these two tasks to differ between left and
right hemisphere patients with stroke and result in
less accurate classification of the RH group on DFA.
As was expected for a language measure, signifi-
cant overlap was found in MAST performance
Severe language impairments 689
Predicted group membership
Right hemisphere stroke Non-patients
28 (75.7%) 6 (16.2%) 3 (8.1%)
6 (30.0%) 6 (30.0%) 8 (40.0%)
0 (0%) 1 (2.8%) 35 (97.2%)
4 (10.8%)
23 (62.2%) 10 (27.0%) 9 (45.0%)
5 (25.0%) 6 (30.0%) 36 (100%)
0 (0%) 0 (0%)
24 (64.9%) 9 (24.3%) 4 (10.8%)
4 (20.0%) 6 (30.0%) 10 (50.0%)
0 (0%) 0 (0%) 36 (100%)
between the RH group and NP group resulting
in many RH individuals being misclassified as NP.
However, the RH group performed more poorly
than the NP group on four of nine MAST sub-
scale scores as well as on the MAST total and
index scores. These findings may indicate that
performance on the MAST is sensitive to cognitive
impairments associated with right hemisphere
stroke albeit to a lesser degree than by cognitive
impairments associated with left hemisphere stroke.
As noted above, some of the sub-scales of the
MAST have visual-perceptual demands. These sub-
scales include object recognition from a field of five
and following written instructions. These tasks can
be particularly difficult for patients with left neglect.
This visual analysis component of the MAST may
partially explain sensitivity to right hemisphere
injury. An additional MAST sub-scale (following
verbal instructions) involves following instructions
that progress in length. This task requires several
cognitive abilities including language comprehen-
sion, attention/concentration, left/right discrimina-
tion and body schema. Cognitive impairments
in these domains (particularly attention) may
have impacted performance on this sub-test for
individuals in the RH group. The writing to dictation
sub-scale of the MAST requires motor performance
that may be affected by left neglect or other visual-
perceptual impairments. Performance was similar
for both the RH and NP groups on the sub-
scales that were primarily language dependent (i.e.
automatic speech, repetition and yes/no accuracy).
This initial investigation into the psychometric
properties of the MAST indicated good criterion
validity. However, this study had many limitations.
This study utilized a convenience sample. Subjects
were individuals who were admitted with either
690 R. Nakase-Thompson et al.
a right or left hemisphere stroke and who also
received neuropsychological consultation. Individ-
uals with bilateral findings were not included along
with individuals not receiving neuropsychological
consultation. Additionally, the three samples were
not equivalent across demographic characteristics
(i.e. age and education) which required statistical
control for these factors in examining the psycho-
metric properties of the MAST. Future research
should address these limitations and include investi-
gation into other aspects of the psychometric proper-
ties of the MAST. Investigations into the MAST’s
relationships with other measurement tools, utility
with other patient populations and reliability (i.e.
inter-rater reliability) are indicated.
The MAST was developed in response to the need
for a brief screening measure that could be adminis-
tered at bedside or clinic appointments by a variety
of health-care providers. Clinicians are frequently
asked to comment on cognitive abilities including
communication skills and language function. This
has implications for implementing medical and
rehabilitation interventions, monitoring the course
of recovery of language impairments and providing
feedback to families for education and discharge
planning. The MAST promises to be a useful tool
in this regard. This brief measure provides a practical
method for evaluation of language abilities that
is amenable to repeated evaluations over time.
Acknowledgements
The authors would like to acknowledge the following
for their assistance in completion of this project:
Wing Ng, MD, Sid Dickson, PhD, Brook Bible,
SLP, Robert Adams, PhD, Ashley Doughty, MA,
and Candice Harris, BS.
References
1. Kertesz A, McCabe P. Recovery patterns and prognosis in
aphasia. Brain 1977;100:1–18.
Appendix 1: A sample of MAST individual items
Naming [5 items] (‘What is this called?’)
(1) ______Pen
(2) ______Hand ( point to both sides of your hand )
Automatic Speech [5 items] (‘Finish these sentences for me’)
(1) ______Count to ten (1 ¼ cueing required)
(2) ______I pledge allegiance to the
Repetition [5 items] (‘Repeat these words’)
(1) ______ pot
(2) ______The silver moon hung in the dark sky
Following instructions [5 items]
(1) ______‘Point to your nose’
(2) ______‘Before opening your mouth, touch your ear’
2. Uzzell BP, Zimmerman RA, Dolinkas CA, et al. Lateralized
psychological impairment associated with CT lesions in head
injured patients. Cortex 1979;15:391–401.
3. Tate RL, Lulyham JM, Broe GA, et al. Psychosocial outcome
for the survivors of severe blunt head injury: The result form
consecutive series of 100 patients. Journal of Neurology,
Neurosurgery, & Psychiatry 1989;52:1128–34.
4. McClenahan R, Johston M, Densham Y. Misperceptions of
comprehension difficulties of stroke patients by doctors,
nurses, and relatives. Journal of Neurology, Neurosurgery, &
Psychiatry 1990;53:700–01.
5. Kertesz A. Western aphasia battery test manual. The
Psychological Corporation; 1982.
6. Goodglass H, Kaplan E. The assessment of aphasia and
related disorders. Malvern: Lea & Febiger; 1983.
7. Spreen O, Strauss E. A compendium of neuropsychological
tests. New York: Oxford University Press; 1998.
8. Powell FE, Bailey S, Clark E. A very short version of the
Minnesota aphasia test. British Journal of Social and Clinical
Psychology 1980;19:189–94.
9. Helm-Estabrooks N, Ramsberger G, Morgan AR, et al.
Boston assessment of severe aphasia. Chicago: Riverside;
1989.
10. Nicholas ML, Helm-Estabrooks N, Ward-Lonergan J, et al.
Evolution of severe aphasia in the first two years post onset.
Archives of Physical Medicine and Rehabilitation 1993;
74:830–37.
11. Benton AL, Hamsher K, Sivan AB. Multilingual aphasia
examination third edition. Iowa City: AJA Associates; 1994.
12. Enderby P, Crow E. Frenchay aphasia screening test: Validity
and comparability. Disability and Rehabilitation 1996;18:
238–40.
13. Derenzi E, Vignolo L. The token test: A sensitive test to
detect receptive disturbances in aphasic patients. Brain 1962;
85:665–78.
14. Kaplan EF, Goodglass H, Weintraub S. The boston naming
test, 2nd ed. Philadelphia: Lea & Febiger; 1983.
15. Brooks DN, Deelman BG, Van Zomeren AH, et al. Problems
in measuring cognitive recovery after acute brain injury.
Journal of Clinical Neuropsychology 1984;6:71–85.
16. Still CN, Goldschmidt TJ, Mallin R. A new brief clinical
assessment for aphasia-apraxia-agnosia. Southern Medical
Journal 1983;76:52–4.
17. Biniek R, Huber W, Wilmes K, Glindemann R, Brand H,
Fiedler M, Annen C. Ein Test zur Erfassung von Sprach- und
Sprechstorungen in der Akutphase nach Schlaganfallen.
Nervanarzt 1991;62:108–15.
18. Available online at: http://www.tbims.org/combi/mast/index.
html
 Severe language impairments 691

Yes/no responses [10 items] (‘I’m going to ask some questions; just tell me yes or no’ )
(1) ______Am I touching my eye (clinician touches his/her nose)?
(2) ______Do you put your shoe on before your sock?
Writing/spelling [5 items] (‘Now I would like for you to write some words for me, spell ______’)
(1) ______sit
(2) ______computer
Object recognition in a field of five [5 items] ( ‘I want to show you some things, point to them as I call them out’)
(1) ______Watch
(2) ______Keys
Reading instructions [5 items] (‘Read this aloud and do what it says’)
(1) ______Open your mouth
(2) ______Point to your left ear after you make a fist.
Verbal fluency dictation: [SIDEWALK] write all words that the patient verbalizes and code unintelligible
utterances with a dash (‘!’); OR TAPE PT RESPONSE AND TRANSCRIBE AFTERWARDS.
INSTRUCTION: Show the photo (10 seconds) and say, ‘Look at this picture for a while (pause) Now tell
me everything that you can about this picture; keep talking until I tell you to stop’, immediately start timing
for 10 seconds.